What is contraception?
Contraception (also known as birth control) is a range of methods, devices, medicines or surgeries that can be used to prevent surgeries.
The first kind of contraception was used thousands of years ago (specifically in 1850 BC, in Ancient Egypt and Mesopotamia). Yet, it only became legal in the UK around 60 years ago. It was first approved in 1961 for married women and later legalised for all women in 1967.
Today, a huge amount of people around the globe rely on these ways of contraception. A UN report has even found that in the UK, 71.1% of women who are married or in couples use contraception.
The legalisation of birth control was a huge milestone for women’s rights. Yet it’s important to keep in mind that most of the contraception methods available are mostly tailored for women and there is only a small amount of birth control available for men.
However, there is currently forthgoing research into more male contraception and scientists predict that there should be more to come in the future. This article should be able to present and inform you about birth control but also the male contraceptive pill in specific.
What different methods of contraception are already available?
Types of contraception for females:
1. Contraceptive diaphragm or cap:
Vaginal diaphragms are circular domes with a flexible rim and cervical caps are smaller. Both are made out of silicone, fit inside the vagina and cover the cervix. They can be bought in different shapes and sizes.
2. Combined oral contraceptive pill:
Also known better as “the pill”, it keeps ovaries from releasing an egg. The pill also causes changes in the cervical mucus and the lining of the uterus (endometrium) to keep sperm from joining the egg.
Different types of birth control pills can be bought. These differ as they all contain specific doses of oestrogen and progestin. This pill presents many health risks (such as breast cancer and blood clots) for the women who take them daily.
3. Progestogen-only pill:
This is also a pill which needs to be taken every day. This pill releases the progestogen hormone which prevents a pregnancy from taking place as it thickens the mucus in the neck of the womb, making it harder for the sperm from penetrating and reaching the egg. It can also prevent women from releasing their eggs each month. Equally, there is less chance of a fertilised egg implanting itself into the womb.
4. Female condoms:
These are long latex-free rubber pouches which line the walls of the vagina and that collect semen and other fluids during intercourse.
5. Contraceptive implant:
This is a small flexible plastic rod, which is implanted under the skin in the upper arm. This releases a hormone named progestogen into the bloodstream, which prevents the release of an egg each month. These last for around three years.
6. Contraceptive injection:
This injection works similarly to the contraceptive implant: it releases the progesterone hormone into the bloodstream and this prevents the release of an egg each month. Yet, it works for a shorter period: a total of 8 or 13 weeks.
7. Contraceptive patch:
This is a small sticky patch that releases a daily dose of hormones (such as oestrogen and progestogen) through the skin into the bloodstream. This can prevent ovulation. These patches work each for a week.
8. Intrauterine device:
Also known as IUDs, this is a small T-shaped copper and plastic device, which is implanted into the uterus and lasts for around 5 to 10 years.
This device releases copper into the womb, which then alters the cervical mucus. This makes it more difficult for sperm to reach the egg and also survive. Furthermore, it can prevent a fertilised egg from being able to implant itself.
9. Intrauterine system:
Equally known as IUS, this is a small T-shaped plastic device that’s put into the womb by a doctor or nurse (similarly to an IUD implant). Yet, instead of releasing copper into the womb like the IUD, it releases the hormone progestogen. In turn, this thickens the cervical mucus, which prevents sperm from moving through the cervix. It also thins the womb's lining so that the egg has less chance of implanting itself.
10. Vaginal ring:
This is a prescription-only method of contraception. It’s a small, flexible, plastic ring that can be implanted into the vagina. It works by releasing doses of oestrogen and progestogen hormones into the bloodstream, which prevents the release of an egg. It can equally thicken the cervical mucus, making it difficult for sperm to move through the cervix. A fertilised egg would also have less chance of implanting itself.
11. Female sterilisation:
This is an operation which permanently blocks or seals the fallopian tubes, which prevents sperm from reaching the egg.
As we can see most of these birth control techniques are hormonal methods. These are in reality extremely effective methods, which show a very low risk for women to become pregnant.
Yet, as with all drugs, there are benefits as well as potential health risks such as: -cardiovascular issues
-weight gain, etc…
Types of contraceptive methods for males:
1. Male condoms:
These are the only type of contraception that can prevent pregnancy as well as protect against sexually transmitted infections. The condom is rolled onto an erect penis before intercourse and forms a physical barrier which blocks semen from entering the body of a sexual partner.
2. Male sterilisation:
Also known as a vasectomy, this is a surgical procedure which cuts, blocks or seals (using heat) the tubes that carry a male’s sperm. This works as it prevents the sperm from getting into semen (the fluid that the male ejaculates). This procedure is very quick and only takes around 15 minutes. It is not always possible to reverse a vasectomy.
As you can see, there are only two types of contraception available for men currently. This has raised many questions regarding the disparity between the amount of birth control for women and men. This contrast in number (11 methods for women and 2 for men) is especially problematic as it forces women to be held responsible for preventing pregnancy. This is also accompanied by the various health-related risks of contraception that women need to bear.
This is why there is a lot of ongoing research into new methods of contraception for men. Yet, trying to create a male pill has been proven to be extremely difficult. Equally, most of the drugs currently undergoing trials target the male sex hormone (called testosterone), which can potentially lead to risks.
These side effects can range from:
-increased cholesterol levels
Promising new studies have shown the possibilities for a male contraceptive pill, which is non-hormonal.
The male contraceptive pill
In the UK, the most popular form of prescribed contraception is the “pill”. Yet, the only “pill” available currently is solely reserved for females. As said previously, there is no current pill for male usage. However, there have been a few different types of a “male pill”. Here are a few:
The team (led by Dr Gunda Georg) used a drug, named YCT529.
The researchers targeted the protein called retinoic acid receptor alpha (also known as RAR-α). This protein has an important role in cell growth, embryonic development as well as sperm formation.
The YCT529 drug was able to shut off the RAR-α protein, therefore reducing the development of sperm.
The male mice were given a dose every day for four weeks. This was able to reduce the sperm counts in mice and was also 99 per cent effective in reducing the pregnancies in the test group.
The pill created by the researchers at the University of Minnesota had no observable side effects. This pill is equally reversible: 4-6 weeks after the mice stopped receiving the compound, the mice could father pups again.
Human trials are expected to begin this year.
The study took place on forty healthy men at LA BioMed and the University of Washington and lasted a month.
The 11-beta-MNDTC pill is, contrary to the YCT529, a hormonal pill. It works by blocking sperm production. In a small trial which was conducted, it was successful in causing the hormones required for sperm production to drop.
Among men receiving the pill, the average circulating testosterone level dropped as low as in androgen deficiency, but the participants reportedly did not experience any severe side effects.
Some men experienced some mild side effects such as:
-lower sex drive and mild erection difficulties
However, none of the participants stopped the trial due to these side effects.
When will the male contraceptive pill be available?
There is currently no available male contraceptive pill. Researchers have an optimistic view that a safe, reversible and effective method of male contraception will become available in the next several years.
There are many trials underway for various male birth control methods, but these also need to be approved and made available by the NHS. This also takes time as all new medication has to be rigorously tested and trialled to make sure it is safe and effective for many people.
Are there other types of male contraception currently being tested?
Other than the male contraceptive pill, there have been other promising methods of birth control which are being tested at present. Here are some of these various types of contraception:
Male contraceptive gel
The NES/T is a hormone-based gel which contains synthetic forms of progesterone and testosterone. The gel is rubbed into the shoulders and chest area once a day and is absorbed quickly into the bloodstream. It is designed to reduce sperm production.
Male contraceptive injections
This injection consists in using synthetic progesterone to halt sperm production and synthetic testosterone to counter any unwanted side effects. During a trial, this contraceptive injection was found to be as effective as the female pill.
However, this type of birth control has shown some mild side effects (which can settle in time), such as:
-lower sex drive
These injections would also take around three to six months to start working and about the same amount of time to wear off. This method would also not work fully for one in 25 men who use it. For these men, the injection would not completely halt the sperm from being produced.
A method that does not involve the use of hormones is RISUG (also known as “reversible inhibition of sperm under guidance”). This involves injecting a non-toxic chemical into the vas deferens (a tube that transports sperm to the urethra). The chemical blocks and kills the sperm that passes through the tube.
When the contraception is no longer wanted then another injection can dissolve the chemical.
Intra-vas device (also called IVD) is similar to the RISUG method as it also doesn’t use hormones. It is a physical plug which is injected into the vas deferens and works by blocking the normal flow of the sperm.
Removing the plug is needed to reverse its effect.
This method is thought to be very effective but trials for this device are still ongoing.
As expressed above, male contraception that is currently available is unfortunately limited. It’s currently limited to either condoms (which aren’t always effective; with typical use, they are 85% effective) or a vasectomy (which can’t always be reversed). However, a wide range of methods of male birth control (like the “male pill”) is currently being tested and trialled. These should hopefully be approved in the years to come.
For more information, please visit our sexual health page here
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